Organizations to support a bottle-feeding mom?
November 1, 2016 5:10 AM   Subscribe

I know about La Leche. But are there organizations out there who will offer support to a bottle-feeding mom? More inside..

I'm home now with my fantastic baby following a straightforward and swift delivery a week and a half ago. The one issue we've had has been the feeding. Baby had trouble sucking at first, and there were issues with my supply. He had to ingest certain quantities at the hospital due to the testing required for my GDM and so the nurses gave us bottles to supplement. The issues on both my end and baby's end never really resolved and we made the decision to continue bottle-feeding him.

The hospital, in my mind, treated us appallingly. I understand why they promote breast-feeding so aggressively. I appreciate that they offer a ton of support for that. But I felt like once we had reached the point in the decision tree where we were going the other way, they should have transitioned into teaching me how to bottle-feed the baby properly. This never happened. About 20 minutes before we were released, there was a shift change and a sympathetic new nurse gave us about 20 ready-to-serve bottles to take home. We fed him these for two days while I used a combination of the internet and advice from my sister-in-law to figure out the rest.

Where we stand currently---

1) Baby is gaining weight and producing diapers. Pediatrician weighed him twice over the last week and he is progressing well. She has no issues with bottle-feeding and is watching to make sure he is on track.

2) Baby still cannot grasp burping. He noisily sucks on the bottle until he either a) coughs/sputters, spits it out, cries, tires himself out from the crying and falls asleep or b) I take the bottle away, he cries to get it back, tires himself out from the crying etc. All the gas gets pooped out. I have never changed a just-pee diaper, he poops every time.

3) The noises he makes when he eats can be alarming. He squeaks like a kitten. Hen sucks and gasps at the same time. I'm worried he'll choke! We are using a low-flow bottle. I don't know how else to get him to pace himself and whether what he is doing is normal behaviour.

4) I have a lot of anxiety around the bottle preparation process. I'm washing them out after every use, and running them through a microwave sterilizer in batches when I accumulate four of them. I've heard sterilizing isn't strictly necessary but in case my washing isn't thorough enough, I figure it offers extra protection. With that said, I'm not really clear on what the dangers are to the baby is this process really is not thorough enough. If he drinks from a bottle that is somehow only 95% clean, what will happen to him?

I suspect my anxieties over this issue are being amplified by my lingering anger over how I was treated at the hospital, and I also have some predispositions toward postpartum anxiety which I am self-aware enough to recognize may be coming into play. So I am wondering what resources may be available to me for support, given that I am not breast-feeding. I'm willing to pay if this support is not available through the health care system. What I need is someone who can meet with me at my home or in their office, watch me feed the baby, reassure me about his feeding behaviour being normal and give me some tips to make the whole process go more smoothly. Does such a professional exist? How might I contact one?
posted by ficbot to Health & Fitness (25 answers total) 1 user marked this as a favorite
Baby still cannot grasp burping. He noisily sucks on the bottle until he either a) coughs/sputters, spits it out, cries, tires himself out from the crying and falls asleep

- Have you tried different shaped teats? There are various types that claim to reduce wind.
- Every baby is different with burping - some do best lying on their stomach, or over your shoulder, or sitting sideways on your knee and being leant forward and back (side to side from your POV), or gently lifting up and down, or patted on the back firmly while being bounced, or... you get the idea.

I am no baby expert although I have had two, but maybe move up to a slightly higher flow teat? It sounds like he might be sucking really hard because there's not enough coming out and the result is the squeaking noises from sucking in extra air.

If you're worried about choking, maybe have him lie a bit more on his side (as he would if he was breast feeding) or sitting up a bit.

Regarding options for support etc, where are you? US?
posted by EndsOfInvention at 5:19 AM on November 1, 2016 [2 favorites]

Oh and
"tires himself out from the crying and falls asleep"
there is literally nothing wrong with this, if your baby is eating and falling asleep (and pooping) then you have a 100% perfectly functional baby.
posted by EndsOfInvention at 5:21 AM on November 1, 2016 [13 favorites]

According to this NY Times article, your bottle cleaning regime is more than what the American Academy of Pediatrics recommends. It sounds like doctors, at least in the U.S., are no longer saying you need to necessarily sterilize bottles. This brief article from the Academy mentions that pediatricians aren't as concerned about the issue as they were a generation ago. If you don't have clean water where you live, then it sounds like sterilizing might be more necessary.

(I'm sorry the hospital treated you that way. The same thing happened to my sister years ago when she had my nephew.)
posted by Alluring Mouthbreather at 5:39 AM on November 1, 2016 [2 favorites]

Maybe some will judge me for not sterilizing my bottles all the time...but I didn't. For anything new, we would sterilize. After that it was wash in really hot water and boil the bottles/nipples about every week or so. I don't think you're doing anything wrong there. You can get long handled bottle brushes to make it easier if you don't already have one.

For preparing formula I would make a batch in the morning that would last the until the evening or would put the water into the bottles up front and the add formula as needed. I was lucky with a baby who would eat non-warmed milk though.

Agree to try a couple different nipple/bottle combinations and different feeding positions. Mine was weird in that he wanted to be sitting almost straight up with his head tilted back.

A baby gaining weight and producing wet/dirty diapers is doing what it's supposed to do. So please take comfort in that even with some of these very natural worries.

When not on my phone I will see if I can find any of the online resources that helped me.

Congratulations on your little one!
posted by MandaSayGrr at 5:45 AM on November 1, 2016 [4 favorites]

Check with your pediatrician 's office or hospital about any new mother's groups in your area. I went to one sponsored by the hospital where I delivered and it was a godsend to meet with other women in the same stage of WTF Baby! that I was. So many of the "is this normal" thoughts would be answered there. I ended up making friends with a few women and we broke off and formed our own group.

I agree with the above, if your little one is eating, crying, popping and sleeping, you are A-OK. Congratulations, and you can do this!
posted by msbubbaclees at 5:48 AM on November 1, 2016

Have you tried feeding baby a little bit sooner? It seems like part of his problem is that he's crazy hungry when the bottle gets introduced. If he's at all hungry at regular intervals, try offering the bottle before he's crying for food.

As for the gas, you may be able to help it pass through by laying baby on his back and gently bicycling his legs to his belly.

It's great that your pediatrician is supportive. If it's not too far off, all of these questions would be good to ask her (including recommendations for extra support resources).

Good luck, trust your instincts, and congratulations, you're doing a great job!
posted by Night_owl at 5:56 AM on November 1, 2016 [1 favorite]

Yeah, we got a lot of pressure from the hospital to breast feed too, and it didn't get better until I basically had a physical health crisis AND a meltdown that was bad enough for me to end up needing clearance from the post partum psychiatrist before they would discharge me. I'm so sorry you had such shitty treatment.

On the burping: our bottle-fed baby didn't learn how to burp for about a month. Like, apparently it's a skill? And one that confounded him, and when he belched, particularly in the beginning, &5 seemed to startle him. And our pediatrician was totally fine with that, and said it was normal. He also showed us how to grip baby's feet with our hands and bend his legs to press air from his belly, to help him burp and fart. A doctor at the hospital also shows us (and we had a lot of luck with) gently massaging the baby's lower stomach, just above the hips.
posted by joyceanmachine at 5:58 AM on November 1, 2016

On the professional: we thought about getting a post partum doula, but worried about getting one that wasn't friendly to bottle feeding and formula. Instead, we had a visit from a visiting nurse, arranged by our health care. Assuming you are in the US, my understanding is that you should call your insurance provider/your health care liaison at your employer to see what is avila le there. Failing that, if you call your pediatrician's office and ask if there is a visiting nurse service that they contract with, that should get you what you need.
posted by joyceanmachine at 6:03 AM on November 1, 2016

Where are you located? In our case, the best aid was a local organization, the Breast Feeding Center for Greater Washington.
posted by ryanshepard at 6:07 AM on November 1, 2016


We tried lots of different kinds of bottles and finally settled on the kind with disposable drop-in liners. Because they collapse as the baby eats, less air gets sucked in, which meant less burping and gas (for our kids, anyway). They also eliminated some of my "is the bottle clean enough?" worries.

For gas, we either bicycled baby's legs or held baby stomach-down on our arm and walked around the house, bouncing them gently.

I don't know where you're located, but there are several "Fearless Formula Feeders" groups on Facebook that are set up to provide practical advice & support. Here's the one for Baltimore.
posted by belladonna at 6:11 AM on November 1, 2016 [4 favorites]

Both burping and pooping without drama are learned skills because human infants are basically larval until about month 4. This is normal and every baby learns how to do both differently (I breastfed but no one talked to me about these sorts of things either--it was all just the physical mechanics of it, nothing about timing of feeds or burping or pumping/bottle-feeding or anything like that). I think going home from the hospital feeling like there's an instruction booklet that someone forgot to give you is normal. Be gentle with yourself.

I found that sitting baby up on my lap facing out, supporting his neck and then leaning him slowly and gently forward both produced a burp and about 50% of the time also resulted in a nice, relaxing BM. Patting him on his back over my shoulder or whatever was useless.
posted by soren_lorensen at 6:13 AM on November 1, 2016 [1 favorite]

Best answer: Babies are very noisy eaters ... mine sounds like a pig snuffling around for acorns on a quiet day. Also, formula-fed babies poop more often than breastfed ones; formula isn't digested quite as efficiently as breastmilk, so more poop gets produced.

I'd also think your pediatrician or pediatrician's nurse could watch a feed and offer some thoughts on the franticness and whether that's just him or whether you could try some different techniques. The number one thing is to make sure you have the bottle far enough in his mouth, and angled so the nipple hits the roof of it pretty far back ... That triggers the sucking. Far enough back you as an adult would gag. New parents often give the baby only the tip of the bottle, which is frustrating for the baby and also creates extra gas; if you're a little firmer and push it a little further in, that may settle him down. Having your pede observe would also help you diagnose or rule out reflux, since refluxy babies squirm in characteristic ways from the discomfort.

They do improve at the eating, burping, farting, pooping stuff all with time. As well as the franticness ... Eventually they figure out HOW to eat instead of just reflexively screaming until someone triggers their sucking reflex. Once they realize "Oh, I can suck on this ON PURPOSE to eat," you'll get a lot less of that and they can cooperate with you instead of you having to do everything for them but swallow.
posted by Eyebrows McGee at 6:35 AM on November 1, 2016 [3 favorites]

Best answer: (I am a postpartum doula; I am not your postpartum doula.)

Despite joyceanmachine's concerns, if your budget allows, a few visits from a postpartum doula might be helpful. We are both trained and experienced in what normal newborn babies are like, and particularly for people who are prone to anxiety and don't have helpful family around, it can be nice to have someone pop by and say, "Oh, look how normal your baby is!" or "It looks like you need help with this thing; I can help/know someone who can." Literally some of my visits with first-time parents have involved me puttering around the house making food, washing dishes, and folding laundry while the parents say, "His poop is green. What does green poop mean?" or "Is this thing she does with her face normal?"

Look (or have your spouse look) for an established doula or group that deals with multiples and premies -- they will know how to help with bottles, and they'll know formula protocols. They shouldn't be judgmental about formula, but it might be helpful to mention it up front as a specific thing you want help with.

You may also find to be a helpful resource.
posted by linettasky at 7:16 AM on November 1, 2016 [5 favorites]

I hear you on the hospital bullshit: I decided to formula feed my second kid right at the hospital and I got an astounding amount of passive aggressive and condescending shit from the nurses. Pediatricians were great, and I finally found a lactation consultant (who turned out to be my neighbor! We still see each other!) who gave us great tips for formula feeding a newborn.

- Sit them up to feed at first so the bottle is almost horizontal to prevent overeating and help him pace himself. Make him work for it, it'll help with the sucking and the gas.
- We used the same type of bottles (Comotomo bottles, btw, the wide mouth and nipples make them really easy to clean) as we did with our older daughter and he took to them well so we never had to experiment. Consider switching brands and nipple types until you find one that works for your baby, this is truly an individual preference.
- I sterilize, but that's because I'm a nut and it makes me feel better. I did the microwave bags the first time around and with the second kid I actually bought a countertop steamer and it made my life sooooo much easier.
- Burping: some kids burp easy and some don't. Lean them upright on your shoulder and start patting their lower back all the way up their shoulders, like you're patting a burp out of them by moving it up and out. Much more effective than just back patting. If they're not spitting up everywhere don't worry about lack of burps, though, it's really not a huge problem unless they are uncomfortable.
- Pooping: newborns don't have strong enough abdominal muscles to poop or fart without straining. They sound like they're going to through hell to toot or poop but they're really just exercising and learning how to do it! As long as the kid is not constipated (and that's due to hard poops, not frequency of poops) you're all good. For formula fed babies expect fewer and firmer poops overall, but that's not a given.

Congrats! Your baby is eating and peeing and pooping! You're doing great! Ask your pedi to watch you feed the baby if you're concerned, they will absolutely help out and give you pointers.
posted by lydhre at 7:16 AM on November 1, 2016 [4 favorites]

Seconding linettasky, if you can find a postpartum doula, it was the single best thing that we did. I did a combination of breastfeeding, pumping and formula feeding from the beginning. At around the 5 month mark, I gave up breast entirely because I never could get my supply up. My postpartum doula knew every kind of feeding thing. She helped with my milk supply and strategies to get more milk going but at the same time she also helped with understanding formula and bottle feeding and all kinds of other things. It was informative to watch her handle my baby and also to have her offer tips, tricks and assurances for what I was doing. It was also really helpful to my husband. He had lots of questions and she was brilliant about getting him set up with an infant carrier and comfortable with that with our baby. When she was a newborn, he'd put her in a carrier and bounce on a yoga ball in the living room while playing video games so I could get a solid nap. Heh.
posted by amanda at 7:45 AM on November 1, 2016 [1 favorite]

Sending you hugs and good vibes! You are doing the best thing for your baby in making sure he's getting the nutrition he needs. Formula is healthy food for babies. We gave our daughter plenty of it. La Leche kind of creeps me out, personally, especially after I learned it was started by a conservative religious group, which isn't for me. Oh, and the disdain for single parents in that group??? Ugh. ANYWHO:

I may of missed it, but what does your baby's pediatrician say? Is s/he supportive of you? If not, maybe look for a pediatrician who isn't guilt tripping you? We love ours because she gets us back down to earth about what the facts say when we mention our worries during checkups. Maybe ask at the 2-week checkup? It's everything to feel like you and your child's pediatrician are a team.

Is PEPS (Program for Early Parenthood Support) active in your area? It's a support group where you're matched with several other parents with babies born within a month or so of your baby, and you meet once a week for eight to ten weeks and just talk about what's going on for you. It had no agenda other than talking, listening, and support. We still get together with our group about once a month - we really bonded with those people! Also, they are supposed to match you with parents who live close to you, so you have a built in network of babysitters who know your kid, know your parenting style, and who have kids the same age. In our group, there were a variety of different takes on formula v. breastfeeding, but everyone was supportive of each other.

We never sterilized bottles like you describe, we just washed them in warm soapy water. We never had a problem with her being sick or anything.

Do you think it would make it easier to not use low-flow nipples? If he doesn't need to work as hard for food, he may relax during feedings. It also sounds like he just needs a lot of food, and he's using it if he's filling every diaper!

Also, it will get easier to find support as he grows - right now at a week and a half it can be isolating but even within a few weeks you can start taking him to baby story time (again, if your local library has story time for babies) and meet other parents who've been there. Outside the hospital (and shame on them for how they treated you) are millions of parents doing the best they can and yes, many of us feed our kids formula!
posted by Pearl928 at 8:44 AM on November 1, 2016 [1 favorite]

I have breast and bottle fed. I never sterilized my nipples OR the rubber ones. Seems like unneeded fuss.
posted by pearshaped at 9:39 AM on November 1, 2016 [1 favorite]

Best answer: I wanted to leave a note of support as the father of a 3 month old; I remember that we were a sleep deprived mess at one week out. Basically my experience with parenting advice was a lot like my experience with dating advice: there are a lot of people out there who are willing to tell you that you're doing it wrong, and everybody's situation is unique. I wanted to reassure you that we were told that if the baby is gaining weight and peeing/pooping on schedule, you're doing OK.

Like you, our hospital really pushed breastfeeding, but my wife wasn't having good luck with it, so we went to formula a few days after. We also found that formula made a huge difference in letting us take turns feeding the baby, so we could take shifts and get some consolidated sleep.

For what it's worth, I think our instruction with bottle feeding was fairly rudimentary; I think it was covered in either What to Expect the First Year or Baby 411.

What bottles are you using? We're using the Avents and some Dr. Brown's; the Avents are a little easier, since the Dr. Browns have a lot of little fiddly parts, but the kid seems to enjoy eating out of the Dr. Browns more. Also the Dr. Browns are physically larger and don't fit in our cooler packs as easily. In terms of sterilization: I think we did it once, for the first time, and we just run them through the dishwasher.

Our child is a noisy and enthusiastic eater. I think this is normal. In terms of burping, I was able to generally get a burp out of leaning her forward and rubbing/patting her back. The over the shoulder worked sometimes but generally resulted in milk on the floor behind me/all over my back.

FWIW, our pediatrician told us to contact her with any questions, and seemed OK with us asking questions about feeding/sleep, etc.

Congratulations on your new baby!
posted by Comrade_robot at 10:51 AM on November 1, 2016

My understanding is that the recommendation around bottle sterilization (ie, not doing it) was based partly on the idea that a little bit of gut flora is good - so barring feeding your baby from a filthy bottle or your baby having an unusually sensitive tummy, regular washing should be fine. The thing you're generally trying to avoid by cleaning your bottles is the dehydration that accompanies from a bad/chronic case of diarrhea. In my experience, if you try to rinse the bottles soon after use, they will be easier to keep clean - those ones that sit for hours and hours after being heated can be grosser and harder to clean.

Agree about the post-partum doula - it's very nice, and can calm anxieties, to have someone who has seen a lot of different babies help you to evaluate how far your baby deviates from normal. During the first few weeks, many (most?) babies pretty much poop constantly (and then, suddenly, they sort of stop for days at a time and that's terrifying, too), so I think you're probably ok giving him a little more time to work out the burping strategy. During this constant poop time, it's a good time to use the diaper cream prophylactically.

I also can't recommend enough a new mom's group. Chances are at least one person in your group will be formula feeding (if not, maybe look for a different one), and even if there isn't one, I found it to be generally helpful. Not only did I get advice for my stuff, it also gave me some perspective and let me feel good about some things. Plus, those moms sometimes can direct you to areas of support for specific topics.

And I will repeat what my mom (mother of 4 and labor & delivery nurse) told me: The first 3 weeks are the hardest, and day 10 is the apex of that. That's not exact for everyone, but it seems like a pretty good rule of thumb. And also, follow your instincts, chances are they are good - if you think that what is happening is that your baby hasn't worked out eating and burping yet, that's probably what it is and it might take time and some different techniques or gear (different nipples/bottles) as mentioned above. But if you start to feel like it might be reflux or food intolerance or something like that (and that worry feels like it's coming from a rational place), it's worth following up - I know someone whose baby had severe reflux and she suspected it, despite the doctor insisting not - and it turned out to be bad reflux.
posted by vunder at 11:06 AM on November 1, 2016

I sterilized nipples in a microwave steam bag when I remembered, which was less often than I would like to admit. I used the Playtex bottles with drop-in liners and was very happy with that setup, though I was pumping into and freezing expressed milk in the liners, which added extra justification for the disposable-ness.

Based on what you said, the only thing I would worry about asking your pediatrician is the coordination of breathing and eating, and that only because it's hard to interpret from what you wrote whether it's plain old "newborns are greedy little pigs" or whether there's any cause for concern. Ask to have your pediatrician watch him eat, and they should be able to reassure you (or do something, if anything needs doing)

If pat-burping is not working, you can try lying baby with his stomach on your legs and rubbing his back. We also did baby sitting sideways on your lap leaning forward (head and chest supported in one hand) and rubbing/patting.

1.5 weeks is a SUPER isolating and difficult time, because you're off the adrenaline high, the effects of sleep deprivation have set in for real, and there's no end in sight. It gets better. Baby will figure out how to baby, you'll figure out that the answer to "is this normal?" is almost always "yes" (and hone your spidey-senses for the few occasions where the answer is "no"). Baby will become less of a blob that emits smells and noises and more of an awesome little person who is discovering everything! about! the! world!

Babies have a lot to learn, and although the process of figuring out how to eat and poop can be dramatic, noisy, messy, and disorienting (to you) they are actually really good at figuring all that stuff out.

It gets better. It gets better. It gets better. Memail if you need someone to talk to.

P.S. i was totally the one at library story time with a 1 month old baby sleeping in the bucket carseat. The sole purpose was for me to meet other humans. It was worthwhile.

P.P.S. At 10 days postpartum I was sitting on the couch while the baby screamed inconsolably in the pack-and-play, sobbing and saying to my husband "Can we please just send it back? The only thing I want right now is to put it in a box and send it back." 6 years later I have a kick-ass little partner in crime. Hang in there.
posted by telepanda at 11:06 AM on November 1, 2016 [1 favorite]

Those drop-in liners are a godsend. Try those if you haven't. Lessens the air sucking.

By all means get a postpartum doula if you can find one and in the interim, ask your pediatrician about your concerns. (You may also get a good doula rec this way.) Pediatricians in my experience are way less on the breast feeding zealotry train. They know the only really important things are to feed the baby and not go insane.

I never sterilized beyond the first week or so. Ask your pediatrician if it's really necessary. Mine said the liners were fine. I used filtered water to reconstitute formula though because our water supply has too much heavy metal in it. Never used a bottle warmer either, just warmed the filtered water up in a pyrex in the microwave for 20 seconds then mixed with the powder and filled the liner.

BIG HUGS to you. This is hard, and we're not designed to do it alone.
posted by fingersandtoes at 1:59 PM on November 1, 2016

We handwash our bottles after every feeding (well, we let a few pile up in the sink and wash them all at once a few times a day). We additionally run them through the dishwasher every few days. We boil new bottles per the package directions, but otherwise don't formally sterilize.

You didn't ask, but somebody upthread mentioned it, so I'll tell you that we never bothered warming bottles. Our baby was put on room-temperature formula in the NICU immediately after birth and got used to it that way. We now mix formula with cool filtered water from the refrigerator tap. We tried making bottles ahead of time and keeping them in the refrigerator, but the baby drank the cold, made-ahead formula much more slowly than cool, freshly-mixed formula, so we figured he didn't like it.
posted by liet at 4:17 PM on November 1, 2016

Response by poster: Thank you all for the replies! I didn't even know the name of what to search for, and now I do. We are looking into a postpartum doula. I have already been in touch with one and she is supportive about bottle feeding and is proposing a two-session package which can also cover other things like bathing the baby and preventing diaper rash.

I'm a teacher and have a lot of experience with older kids. With my own, I am just finding myself a little overwhelmed with how small and fragile he seems, and I think getting some reassurances that he is normal for his age and that I am doing the right things will help me relax and enjoy things more. I have an anxiety-prone personality type and I am aware that puts me at risk for postpartum depression issues. If a little money spent on this now can prevent that from happening later, it will be money well spent, I think.
posted by ficbot at 4:51 PM on November 1, 2016 [6 favorites]

Baby still cannot grasp burping. He noisily sucks on the bottle until he either a) coughs/sputters, spits it out, cries, tires himself out from the crying and falls asleep

Infants don't really get burping - your kid included - so you're not alone. Burping is more a thing that's done to them or happens without their control. With my wee ones it involved getting their sternum against my shoulder and then giving them a good firm backrub or pat, sometimes having to go a while before the eventual blessed event.

In the SF Bay Area, Kaiser has feeding specialists who provide good bottlefeeding and breastfeeding advice. I didn't see any pressure/judgement from them regarding bottlefeeding.
posted by zippy at 8:43 PM on November 1, 2016 [1 favorite]

Hey new mamas! Congratulations and hang in there! I'm exclusively pumping because breastfeeding didn't work and it is hard to find resources for anything but breastfeeding, I feel you.

The burping thing is normal and will improve with age. Google Paced bottle feeding and see if that helps, it worked miracles for us and helped with some of the squeaking and gulping.

I run our bottles through the washer and that's it and our pediatrician was fine with that. I use the hot start, hot rinse, hot dry and that's as good as it gets. I keep meaning to sterilize the nipples but I haven't yet and she's still doing fine.

Fed is best, however you get there.
posted by notjustthefish at 10:09 PM on November 1, 2016

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